Here’s how fast things have changed.
Until just a few weeks ago — before self-distancing, before stay-at-home orders — only about 1% of the patient visits in the Carilion Clinic system were being handled “virtually” through video calls or sometimes regular phone calls.
Now, about 75% are.
Here’s another turn-on-a-dime statistic: Before the pandemic, about 5% of American workers worked from home. Now a Gallup survey says 62% are. That’s an awful lot of life that has suddenly moved online — work, school, medicine.
The big question is how much of this will stick once things return to normal, or a “new normal.” The best guess is probably a lot. In the case of all that telemedicine, “I don’t think we’ll put the genie back in the bottle,” says Carilion President and CEO Nancy Agee. “We’ve now learned we know how to do it and we can do it. Our clinicians like it and best of all our patients really like it — it’s convenient.” She cites the case of the patient who had an appointment for a doctor to check on how on they were healing after surgery. No longer does that patient need to drive to the doctor’s office; he or she can simply go online and show the doctor the surgery site. That’s the upside. Now the downside. All this depends on people actually having access to broadband which, as we all know, many in rural areas don’t. U.S. Sen. Tim Kaine, D-Virginia, says one of the ways the pandemic will change things is that it will place even more emphasis on closing what is often called “the digital divide.” The push to do more things online “will dramatically raise the stakes,” he says.
At this point, you’re probably expecting another in our periodic series of editorials in which we bemoan the lack of rural broadband. You’re partly right. We will point out that 550,000 Virginians don’t have access to broadband internet or sometimes any internet at all. Earlier this year, Del. Charles Poindexter, R-Rocky Mount, introduced a bill to prohibit teachers from giving homework that requires internet access. That bill didn’t pass — suburban legislators probably thought Poindexter was being a Luddite. In fact, he was simply reflecting a real-life problem in his rural district. In any case, the call for more rural broadband is a bipartisan one. Democrats and Republicans may argue about the best way to make this happen, but nobody disputes that it should happen.
However, let’s now do something unexpected: Let’s talk about how much has already been done. If this pandemic had come 20 years ago, or even just 10 years ago, rural Virginians would have been almost completely out of luck. They couldn’t have worked online, they couldn’t have gone to school online, and they couldn’t have been able to visit the doctor online. The fact that some still can’t represents a shortcoming — but the fact that many can represents an unheralded success story that ought to be celebrated.
If you live in Southwest or Southside Virginia, the odds are you should credit the Virginia Tobacco Region Revitalization Committee — but even that involves crediting a lot of politicians in both parties, some of which have long since passed from the scene.
A brief refresher: In the 1990s, states began suing tobacco companies, seeking damages for all the health care costs they were incurring for tobacco-related patients. Most states used their tobacco settlement money for health care; some used it to plug ordinary budget holes. Virginia was unusual in that we set part of the money aside — a staggering $1 billion, to be precise — to try to build a new economy in former tobacco-growing regions. The two people most responsible for that were Charles Hawkins, then a Republican legislator from Chatham, and Whitt Clement, then a Democratic legislator from Danville. They persuaded the 1999 General Assembly — and Gov. Jim Gilmore — to approve creation of what’s usually called simply “the tobacco commission” but really has nothing to do with the carcinogenic leaf. We have to wonder whether a more urban/suburban legislature today would have gone along with this plan to give so much money to rural Virginia.
Over the years the commission has come in for its share of criticism for how it’s spent its money; some of that criticism is well-deserved. But the reality is that an awful lot of Southside and Southwest Virginia is now online in a way that wouldn’t have happened otherwise. When Mark Warner was governor in the early 2000s, he was a vocal champion of using some of that tobacco fund money for broadband. He was regarded as futuristic then; now that’s considered commonplace. In all, the commission has paid for more than 3,000 miles of “middle-mile” broadband in Southside and Southwest Virginia. Since 2017, it’s responsible for 108,000 “last mile” connections — to homes or businesses in the 40 localities that are eligible.
As hard as it will be for some, people in rural Virginia — whether in or out of tobacco commission localities — should also thank both the Obama and Trump administrations, because both have made spending billions each year on rural broadband pretty routine — so much so that it’s hard to come up with a “spending to date” figure. Remember the stimulus spending Barack Obama pushed through in his first year? Some $7.2 billion of that went to rural broadband; one small part of which extended the Mid-Atlantic Broadband line to Blacksburg.
Give thanks, too, to the Virginia General Assembly, which under first Republican and now Democratic management has put money into rural broadband. The current budget calls for $70 million over the next two years; Gov. Ralph Northam has set a goal of getting the whole state on broadband by 2028. We’ll see how much of that money sticks as the pandemic economy strangles state revenues. However, some solutions don’t involve money, just creative thinking. Del. Israel O’Quinn, R-Washington County, took the lead on a bill that makes it possible for electric utilities to run broadband lines as part of their “smart grid” technology upgrades. Think of rural broadband as the rural electrification of the modern age — there are a lot of people to thank here.
We have a long way to go but if none of that had happened, rural Virginia today would be almost completely cut off from a new economy and perhaps a new way of life that is taking shape.
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